[Fever and cancer: components of diagnosis for optimal management]

Fever is defined as a body temperature above 37.8°C in the absence of antipyretic drug. It is a frequent and potentially severe event and its interpretation can be difficult in patients with solid tumors. It is usually alleged that more than half of cancer patients will be affected by the occurrence of this event during the course of their disease. Underlying causes are multiple but most frequent and severe causes include infections, the most life-threatening causes being, firstly, febrile neutropenia and secondly, healthcare-associated infections and more particularly infections related to catheter. Opportunistic infections are much less frequent than in hematology oncology but clinicians should be aware of two severe opportunistic infections: systemic candidiasis and Pneumocystis jiroveci pneumonia. Fever related to paraneoplastic or tumor necrosis complicates the diagnosis process. Other common causes of fever include venous thromboembolic disease or more rarely treatment related fever. We aim at examining the optimal diagnostic and therapeutic strategies when facing a cancer patient with fever.